5. EEO-1 Form (To Be Submitted by the Prime and Any Sub with 20% Or More of the Contract)

5. EEO-1 Form (To be submitted by the prime and any sub with 20% or more of the contract).

Name of Firm:
5. Section D- EMPLOYMENT DATA
Employment at this establishment- Report all permanent full and part-time employees including apprentices and on-the-job trainees unless specifically excluded as set forth in the instructions. Enter the appropriate figures on all lines and in all columns. Blank spaces will be considered as zeros.
Job Categories / Number of Employees (Report employees in only one category)
Race/Ethnicity
Not-Hispanic or Latino / TOTAL COL.
A-N
Hispanic or Latino / Male / Female
Male / Female / White / Black or African American / Native Hawaiian or Other Pacific Islander / Asian / American Indian or Alaska Native / Two or more races / White / Black or African American / Native Hawaiian or Other Pacific Islander / Asian / American Indian or Alaska Native / Two or more races
A / B / C / D / E / F / G / H / I / J / K / L / M / N / O
Executive/Senior Level officials and Managers / 1.1
First/Mid-Level Officials and Managers / 1.2
Professionals / 2
Technicians / 3
Sales Workers / 4
Administrative Support Workers / 5
Craft Workers / 6
Operatives / 7
Laborers and Helpers / 8
Service Workers / 9
TOTAL / 10
PREVIOUS YEAR TOTAL / 11
1. Date(s) of payroll period used: ______/ (Omit on the Consolidated Report.)
Section E-ESTABLISHMENT INFORMATION (Omit on the Consolidated Report). What is the major activity of this establishment? (Be specific, i.e., manufacturing steel casings, retail grocer, wholesale plumbing supplies, title insurance, etc. Include the specific type of product or type of service provided, as well as the principal business or industrial activity.)
Section F- REMARKS-Use this item to give any identification data appearing on the last EEO-1 report which differs from that given above, explain major changes in composition of reporting units and other pertinent information
Section G- CERTIFICATION
Check One / 1 / □ / All reports are accurate and were prepared in accordance with the instructions. (Check on Consolidated Report only.)
2 / □ / This report is accurate and was prepared in accordance with the instructions.
Name of Certifying Official / Title / Signature / Date
Name of person to contact regarding this report / Title / Address (Number and Street)
City and State / Zip Code / Telephone No. (including area code and extension) / Email address
All reports and information obtained from individual reports will be kept confidential as required by Section 709(e) of Title VII. WILLFULLY FALSE STATEMENTS ON THIS REPORT ARE PUNISHABLE BY LAW, U.S CODE, TITLE18, SECTION 1001
Description of Race and Ethnic Identification and Job Categories are found @ http://www.eeoc.gov/employers/eeo1survey/2007instructions.cfm / Appendix 4. Race and Ethnic Identification / and Appendix 5. Description of Job Categories